Abstract Body (Do not enter title and authors here): Background and Aims: Cardiovascular disease is a global health concern requiring effective prevention. Colchicine has gained interest for reducing cardiovascular events in high-risk patients. This study evaluates the efficacy and safety of colchicine in preventing these events.
Methods: A systematic search was conducted in PubMed, CENTRAL, and Embase databases according to PRISMA guidelines, including studies up to August 26, 2024. Measures of effect included relative risk (RR) and mean differences. Meta-regressions and sensitivity analyses were performed to explore heterogeneity, which was quantified using the I² statistic. The certainty of evidence was assessed using the GRADE approach.
Results: Analysis of 37,812 patients showed colchicine significantly reduced the risk of acute myocardial infarction (moderate certainty) (RR=0.81 [95% CI: 0.71-0.92], p=0.002), pericarditis (high certainty) (RR=0.48 [95% CI: 0.39-0.59], p<0.00001), atrial fibrillation (high certainty) (RR=0.74 [95% CI: 0.66-0.84], p<0.00001), acute coronary syndrome (high certainty) (RR=0.39 [95% CI: 0.23-0.65], p=0.0004) and hospitalization (high certainty) (RR=0.52 [95% CI: 0.38-0.70], p<0.0001). Outcomes such as cardiovascular mortality (moderate certainty), total mortality (moderate certainty), non-cardiovascular mortality (low certainty), length of hospital stay (low certainty), and cardiac tamponade (very low certainty) did not show statistically significant differences. Significant adverse effects included gastrointestinal disorders such as diarrhea, flatulence, nausea, and elevated ALT or AST levels.
Conclusions: Colchicine effectively reduces cardiovascular event risk but may cause gastrointestinal side effects. Its benefit in cardiovascular prevention is clear, yet safety should be evaluated prudently.